Frenotomy–Parent Perseverance Pays Off

 

20140828_095301Breastfeeding always hurt for first- time breastfeeder, Tina. She was given a nipple shield to help with the pain. And it did help. Even so, she knew a nipple shield was not a long-term solution. She kept trying to get rid of the shield. She hated the thing! But every time baby latched without it it, it resulted in intense nipple pain and wounds—her nipple was painfully creased after feedings as well. So, understandably,  she continued to nurse with the shield.

Meanwhile, baby Carolyn wasn’t gaining weight well. At every appointment she was gaining about ½ of expected weight gain. Baby was breastfeeding frequently—over 10x/day and still not gaining appropriately. She was having infrequent bowel movements, was gassy, and uncomfortable. Tina felt that something was very wrong. Continue reading

Low Milk Supply: Tricky to Treat!

Supplementing at breast

Supplementing at the breast.

When a mom is experiencing difficulty making enough milk for her baby, the usual suggestion from well meaning professionals is often, “Nurse your baby more —your body will rally and you will make more milk in just a few days.” This suggestion is based on the law of supply and demand. When more milk is removed from the breast, the breast will respond by making more milk. While this advice can be legitimate in some situations, many times it can result in an exhausted baby who, despite mom’s best efforts, can’t get enough milk to gain well. Continue reading

Adrienne’s Story–Tongue Tie and Beyond

This is a story from a former client. She wants to encourage other moms to aggressively seek help for breastfeeding challenges. She wants you to know that if you’re having trouble, it’s not your fault! And, finally, she wants you to know that you and your baby don’t have to suffer and struggle in order to breastfeed

20131224_140733By the time I saw Renee, I’d already been to 4 lactation consultants and I was losing hope I’d be able to breastfeed my baby girl for even another month, let alone her first year. We were on week 9 of pain, frustration, and tears. When Renee said my girl had a tongue tie, I didn’t quite believe her for a moment. Then I wanted to cry, I was so relieved to have a concrete, fixable solution. Continue reading

Thankful for Breastfeeding

Thankful for baby bliss.

Thankful for baby bliss.

Recently a client sent me a nice note with a generous check. She had been feeling gratitude for the help she received to breastfeed her son. There were multiple lactation consultations in her home, a frenotomy (the procedure to release a tongue tie) and body work for baby. There were many up-front costs–some of which were not covered by insurance. Here’s what she wrote: Continue reading

Twenty Things You Don’t Know about Tongue Tie

Anterior tongue tie

Anterior tongue tie

The medical term for tongue tie is “ankyloglossia” which literally means “anchored tongue.”

Most health care professionals and many lactation consultants do not know how to evaluate for ankyloglossia.

Obvious does not mean severe. “Obvious” simply means the frenulum is attached near the tip of the tongue making it clearly visible.

An anterior tongue tie refers to attachment near the tip of the tongue. Posterior tongue tie refers to attachment at the base of the tongue.

If the frenulum is attached to the back of the tongue (posterior) it can cause even more restriction than if it’s attached to the front of the tongue (anterior)

There is no such thing as a mild tongue tie. Usually if someone says the tongue tie is mild, that means that the person doing the evaluation isn’t sure if it’s causing a restriction.

Tongue ties affect much more than breastfeeding.

Where the frenulum attaches at the floor of the mouth can have as much or more impact than where it attaches to the tongue.

Frenulum attached to lower gum ridge causing trough in tongue.

Frenulum attached to lower gum ridge causing trough in tongue.

Sometimes the frenulum can be attached to the back of the lower gum ridge as well as the floor of the mouth.

The frenulum does not stretch.

No one “grows out of” ankyloglossia.

The procedure to revise the frenulum so the tongue can move properly is called a frenotomy. It’s also commonly referred to as a revision. (It may be called different things in different parts of the world.)

The frenotomy can be done in about 2 seconds by clipping the tissue. If laser is used, it’s a little longer. It is never too late for a frenotomy!

The frenulum is NOT part of the tongue—the tongue will not be clipped during a frenotomy.

The frenulum usually has few nerves and blood vessels.

You can’t tell by looking if baby needs frenotomy.

A frenulum can not “grow back” once it’s clipped. It can, however, heal in such a way that it continues to restrict the movement of the tongue. It is important to keep the wound open during the healing process.

The frenotomy is often just the beginning of the path to full tongue function. Body work and time to learn new skills are often necessary.

There are no documented reports of any complications from a frenotomy.

In some parts of the world, ankyloglossia is commonly remedied with a long fingernail!

See also, “Squeaker: A Story about a Tongue Tie Release.”